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NPI Code Detail

MEDICARE: CENTRAL QUEENS DAY SURGICAL CENTER, INC.

MEDICARE: CENTRAL QUEENS DAY SURGICAL CENTER, INC.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1261QA1903XAmbulatory Surgical Clinic/Center7003242RNY

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1417922808
Entity Type Code : Organization
Provider Name (Legal Business Name) : CENTRAL QUEENS DAY SURGICAL CENTER, INC.
Provider Business Mailing Address
First Line : 8340 WOODHAVEN BLVD
Second Line :
City : GLENDALE
State : NY
Zip : 11385-7824
Country : US
Telephone Number : 718-849-8700
Fax Number : 718-849-6523
Provider Business Practice Location Address
First Line : 8340 WOODHAVEN BLVD
Second Line :
City : GLENDALE
State : NY
Zip : 11385-7824
Country : US
Telephone Number : 718-849-8700
Fax Number : 718-849-6523
Authorized Official
Title or Position : OFFICE MANAGER
Name : MRS. EMILY DOUKAS
Credential :
Telephone Number : 718-849-8700
Provider Enumeration Date : 02/21/2006
Last Update Date : 06/16/2008

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